Tareq Kass-Hout, MD

Ayerbe L, Ayis S, Crichton S, WolfeCDA, Rudd AG. The Natural History of Depression up to 15 Years After Stroke: The South London Stroke Register. Stroke. 2013.

In a study recently published online in Stroke, Ayerbe and colleagues are studying the incidence, prevalence, duration, and recurrence rate of depression up to 15 years after stroke. Evidence on the natural history and prognosis of depression after stroke is still lacking which complicate treatment strategies. Interventions for depression after stroke has limited effect because it is not started at the right time or not given for an adequate length of time to obtain maximal sustained response.

This is a prospective population-based cohort of 1233 patients, in the South London Stroke Register between 1995 and 2009, showed that the incidence of depression post-stroke was 7-21% in the 15 years following stroke. Thirty three percent of post-stroke depression started in the first three month, half of them recovered after one year. Interestingly, proportion of recurrence ranged from 38% in year two to 100% in year 14.

Post-stroke depression requires periodic clinical attention in the long term. This study shed  light on the high rate of recurrence of depression post-stroke. Assuming that a patient recovering from depression is a “closed case” could lead to a late diagnosis or an overlooking of a further episode.